Wis. ForwardHealth Online Handbook, Hospice, Topic #474

Providers should call Provider Services to answer enrollment, policy, and billing questions. Members should call Member

Services for information. Members should not be referred to Provider Services.

The Provider Services Call Center provides service-specific assistance to Medicaid, BadgerCare Plus, WCDP (Wisconsin

Chronic Disease Program), and WWWP (Wisconsin Well Woman Program) providers.

Ways Provider Services Can Help

The Provider Services Call Center is organized to include program-specific and service-specific assistance to providers. The

Provider Services Call Center supplements the ForwardHealth Portal and WiCall by providing information on the following:

• Billing and claim submission

• Provider enrollment

• Member enrollment

• COB (coordination of benefits) (for example, verifying a member's other health insurance coverage)

• Assistance with completing forms

• Assistance with remittance information and claim denials

• Policy clarification

• PA (prior authorization) status

• Claim status

• Verifying covered services

Information to Have Ready

When contacting or transferring from WiCall to the call center, callers will be prompted to enter their NPI (National Provider

Identifier) or provider ID. Additionally, to facilitate service, providers are recommended to have all pertinent information related to

their inquiry on hand when contacting the call center, including:

• Provider name and NPI or provider ID

• Member name and ID

• Claim ICN (internal control number)

• PA number

• DOS (date of service)

• Amount billed

• RA (Remittance Advice)

• Procedure code of the service in question

• Reference to any provider publications that address the inquiry

Call Center Representatives

The ForwardHealth call center representatives are organized to respond to phone calls from providers. Representatives offer

assistance and answer inquiries specific to the program (for example, Medicaid, WCDP, or WWWP) or to the service area (for

example, pharmacy services, hospital services) in which they are designated.

In addition to trained call center representatives, Provider Services employs an automated tool for assisting callers. The virtual

agent is available 24 hours a day, seven days a week to answer questions that do not require a call center representative, such as

inquiries related to:

• Claim status

• PA status

• Provider payment status

• Member enrollment verification

Walk-in Appointments

Walk-in appointments offer face-to-face assistance for providers at the Provider Services office. Providers must schedule an

appointment in advance by contacting Provider Services at 800-947-9627. Appointments for in-person provider assistance are

available Monday through Friday, 7:30 a.m. – 4 p.m. (Central time), except for state-observed holidays. Providers without an

appointment may not receive in-person assistance and may have to schedule an appointment for a later date.

Written Inquiries

Providers may contact Provider Services through the Portal by selecting the Contact Us link. Provider Services will respond to

the inquiry by the preferred method of response indicated within five business days. All information is transmitted via a secure

connection to protect personal health information.

Providers may submit written inquiries to ForwardHealth by mail using the Written Correspondence Inquiry (F-01170 (07/2012))

form. The Written Correspondence Inquiry form may be photocopied or downloaded via a link from the Portal. Written

correspondence should be sent to the following address:

ForwardHealth

Provider Services Written Correspondence

313 Blettner Blvd

Madison WI 53784

Providers are encouraged to use the other resources before mailing a written request to ForwardHealth. Provider Services will

respond to written inquiries in writing unless otherwise specified.